Hospice Care for Parkinson’s, ALS and Neurological Disease in Metro Detroit

Written and reviewed by the Lily Hospice clinical team. Updated September 2026.

In Medicare’s most recent Care Compare data, 71.3% of Lily Hospice patients were visited by a nurse or social worker in their last three days of life, against a national average of 48.3% and a metro Detroit median of 60.9% across the 104 hospices serving Oakland, Macomb and Wayne counties. “Most families tell us afterward that they wish they had called sooner,” says the Lily Hospice clinical team. “The evaluation is free, and the earlier we meet a family, the more good days we can protect.”

Parkinson’s, ALS, multiple sclerosis and the aftermath of a major stroke share something cruel: the mind is often still there while the body stops cooperating. Families spend years adapting, adding a walker, then a wheelchair, then a lift, and it becomes hard to see where “managing” ends and “it is time for more help” begins.

Hospice for neurological disease is about protecting dignity and comfort through that last stretch, at home or in the facility where your loved one lives, and about making sure the person’s own wishes, spoken while they could still speak them, are the ones that guide care.

Signs it may be time to talk about hospice

Neurologists assess stage and function; the physician makes the eligibility decision. Families usually notice:

• Trouble swallowing: coughing with meals, choking, or a recent aspiration pneumonia
• Speech that is very hard to understand, or gone
• Needs help with nearly all daily activities, or is mostly in bed or a chair
• Weight loss, or eating and drinking much less
• Breathing that is weaker, especially lying flat (common in ALS)
• Repeated infections in the last year: pneumonia, urinary infections, pressure sores
• Falls, or a hospital stay that did not restore function
• Medications that no longer control symptoms the way they used to

If several of these feel familiar, it is not too early to ask. Most families tell us later that they wish they had called sooner.

What hospice does for someone with a neurological disease

Swallowing and nutrition, handled gently. Our nurses and aides teach safe feeding techniques, adjust textures, and manage secretions, so mealtimes are calmer. If a feeding tube is on the table, we will explain honestly what it usually does and does not do at this stage, and support your decision either way.

Stiffness, pain and anxiety treated at home. Rigidity, cramps, restlessness and the fear that comes with breathlessness all have treatments. The nurse comes to you and adjusts quickly.

Equipment and hands. Hospital bed, pressure-relieving mattress, lift, wheelchair, suction, oxygen: delivered under the benefit. Aide visits for bathing and repositioning protect skin and give the family caregiver a break.

Honoring what they told you. Many people with ALS or Parkinson’s have said clearly what they want and do not want. Our social worker helps put that in writing, in the forms Michigan hospitals and paramedics recognize, so it is followed.

Questions families ask

Is Parkinson’s alone enough to qualify for hospice?

Advanced Parkinson’s can qualify, particularly with swallowing problems, weight loss, recent infections, or being mostly bed- or chair-bound. The physician certifies eligibility; we can do a no-obligation evaluation and tell you where things stand.

What about ALS?

ALS is one of the conditions where hospice often begins earlier, because breathing and swallowing changes can move quickly. If your loved one has declined a ventilator or feeding tube, or is losing weight or breathing strength, it is time to talk.

Can hospice help after a stroke?

Yes, when a stroke has left someone unable to swallow safely, mostly unresponsive, or declining despite rehabilitation. Hospice adds comfort care and support wherever they live, including nursing facilities.

Does he have to give up his Parkinson’s medications?

No. Medications that keep him comfortable and mobile continue. The team reviews the list with you and the physician and keeps what helps.

Do you come to nursing homes in Wayne County?

Yes. We serve all of Oakland, Macomb and Wayne counties, at home and in facilities, from our office in Troy.

Where we come to you

Lily Hospice cares for families at home, in assisted living, memory care and nursing facilities across Oakland County, Macomb County and Wayne County, from our office in Troy. Veterans and their families can read about our veteran-specific hospice care.

General education, not medical advice. Whether hospice is appropriate is a decision made with your loved one’s physician. Medicare hospice eligibility is based on a physician’s judgment that life expectancy is six months or less if the illness runs its usual course; people are not required to stop living past six months, and care can continue as long as they remain eligible.

Hospice isn’t giving up. It’s showing up.

Common questions

Which hospice can admit the same day, including weekends? · Can hospice come to assisted living or memory care? · Hospice for a veteran in metro Detroit · Which hospice is best in metro Detroit? · Is Lily a good hospice? An honest answer · All 104 metro Detroit hospices compared · Who answers a hospice phone at night? · Hospice with Medicaid only or no insurance · Can I keep my own doctor? · How to start hospice this weekend